Individual provider Active NPI

Suzanne Elizabeth Wagster, MA, LPC

  • Professional Counselor
  • Fort Collins, CO
National Provider Identifier
1942451778
Registry record updated May 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0006046 Issued in CO
Practice address
1217 Riverside Ave
Fort Collins, CO 80524-3218
Phone
(970) 494-4200
NPI assigned
Oct 10, 2008
Last updated
May 16, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC.0006046 CO Primary

Addresses

Primary practice location

1217 Riverside Ave
Fort Collins, CO 80524-3218

Mailing address

4856 Innovation Dr Ste B
Fort Collins, CO 80525-5540
Phone (970) 494-4200

Other names 1

  • Suzanne Elizabeth May Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240724000614 CO Practitioner - Mental Health Counselor 4385180546 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians
Sondermind Provider Network LLCGroup PAC ID 9537572490, 1,295 clinicians

Practice addresses (Care Compare)

1024 S Lemay Ave
Uchmg Palliative Care
Fort Collins, CO 80524-3929
Phone (970) 495-8369

720 S Colorado Blvd
PH North
Denver, CO 80246-1904
Phone (844) 843-7279

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Poudre Valley Medical Group, LLC Current Accepting new patients
Poudre Valley Medical Group, LLC CurrentSince May 12, 2024 Accepting new patients
Sondermind Provider Network LLC Professional CurrentSince Aug 7, 2024 Accepting new patients
Mental Health Specialty Group PA Professional CurrentSince Jan 1, 2026 Accepting new patients

Locations

20 E Thomas Rd
Ste 2200
Phoenix, AZ 85012
Phone (310) 515-8113

1560 Broadway
Denver, CO 80202
Phone (623) 363-6103

1024 S Lemay Ave
Fort Collins, CO 80524
Phone (970) 495-7000

720 S Colorado Blvd
Ph N
Glendale, CO 80246
Phone (833) 988-0589

6767 29th St
Greeley, CO 80634
Phone (970) 652-2000

2500 Rocky Mountain Ave
Loveland, CO 80538
Phone (970) 297-6425

2695 Rocky Mountain Ave
Ste 150
Loveland, CO 80538
Phone (970) 624-2412

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557964800000",
    "number": "1942451778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4856 INNOVATION DR STE B",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805255540",
            "telephone_number": "970-494-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 RIVERSIDE AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243218",
            "telephone_number": "970-494-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAGSTER",
        "first_name": "SUZANNE",
        "middle_name": "ELIZABETH",
        "credential": "MA, LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-10",
        "last_updated": "2019-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0006046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUZANNE",
            "last_name": "MAY",
            "middle_name": "ELIZABETH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Collins, CO

Sources for this page

Verify at the official NPI Registry.